Atrial DCM : A new entity in the making

A brief learning session with cardiology fellow about a possible new concept in Left heart failure. What is the commmest cause for acute pulmonary edema? “Left sided heart failure” “Can you be more specific , Left sided means ? “I meant LV failure , typically DCM of any cause or Severe un-controlled HT” “Ok .good. Does Left Heart failure include mitral valve dysfunction also ? “Yes sir, very much. Classical mitral stenosis and Isolated MR can cause pulmonary edema. In fact, acute AR Iis also part of left heart disease” So far, so good, now coming to the complex part of left heart Can LA fail in isolation independent of LV , ie I mean with normal Left ventricle ? I am not sure. Can we call new onset atrial fibrillation as a primary atrial failure that can result in pulmonary edema? Excellent. You are absolutely right. But I am talking about mechanical atrial failure, not electrical. Are you aware that most of the time AF is a well tolerated arrhythmia , it can even be silent in many cases. This is because the pumping function of the atria contributes only 20-25% to LV filling. This can easily be compensated by augmented LV suction force , provided the baseline LV function is normal. Have you heard about ACM. Atial cardiomyopathy? “No sir”, “You will hear more about it soon” (Ref 1) Scientists, especially Echo guys are closing in on this concept. We know, the a...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Uncategorized Atrail dcm atrial cardiomyopathy HFpEF la pressure volume loop primary atrial failure Source Type: blogs